High Levels of 18F-FDG Uptake in Aortic Aneurysm Wall are Associated with High Wall Stress

Xu, X.Y.; Borghi, Alessandro; Nchimi, Alain; Leung, James; Gomez, Pierre; Cheng, Zhuo; Jo, Defraigne; Sakalihasan, Natzi

doi:10.1016/j.ejvs.2009.10.016

Cited by 89 publications

(71 citation statements)

References 15 publications

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“…These observations are extended in the present study. It is worth noting that we were able to correlate the hot spots of 18 F-FDG uptake with high peak wall stress that, in some cases, corresponded to the point of rupture of the aneurysm (22).…”

Section: Discussionmentioning

confidence: 93%

¹⁸F-FDG Uptake Assessed by PET/CT in Abdominal Aortic Aneurysms Is Associated with Cellular and Molecular Alterations Prefacing Wall Deterioration and Rupture

et al. 2013

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Rupture of abdominal aortic aneurysms (AAAs) leads to a significant morbidity and mortality in aging populations, and its prediction would be most beneficial to public health. Spots positive for uptake of 18 F-FDG detected by PET are found in 12% of AAA patients (PET1), who are most often symptomatic and at high rupture risk. Comparing the 18 F-FDG-positive site with a negative site from the same aneurysm and with samples collected from AAA patients with no 18 F-FDG uptake should allow the discrimination of biologic alterations that would help in identifying markers predictive of rupture. Methods: Biopsies of the AAA wall were obtained from patients with no 18 F-FDG uptake (PET0, n 5 10) and from PET1 patients (n 5 8), both at the site positive for uptake and at a distant negative site of the aneurysmal wall. Samples were analyzed by immunohistochemistry, quantitative real-time polymerase chain reaction, and zymography. Results: The sites of the aneurysmal wall with a positive 18 F-FDG uptake were characterized by a strikingly increased number of adventitial inflammatory cells, highly proliferative, and by a drastic reduction of smooth muscle cells (SMCs) in the media as compared with their negative counterpart and with the PET0 wall. The expression of a series of genes involved in the maintenance and remodeling of the wall was significantly modified in the negative sites of PET1, compared with the PET0 wall, suggesting a systemic alteration of the aneurysmal wall. Furthermore, a striking increase of several matrix metalloproteinases (MMPs), notably the MMP1 and MMP13 collagenases, was observed in the positive sites, mainly in the adventitia. Moreover, PET1 patients were characterized by a higher circulating C-reactive protein. Conclusion: Positive 18 F-FDG uptake in the aneurysmal wall is associated with an active inflammatory process characterized by a dense infiltrate of proliferating leukocytes in the adventitia and an increased circulating C-reactive protein. Moreover, a loss of SMC in the media and alterations of the expression of genes involved in the remodeling of adventitia and collagen degradation potentially participate in the weakening of the aneurysmal wall preceding rupture.

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Section: Discussionmentioning

confidence: 93%

¹⁸F-FDG Uptake Assessed by PET/CT in Abdominal Aortic Aneurysms Is Associated with Cellular and Molecular Alterations Prefacing Wall Deterioration and Rupture

et al. 2013

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“…Current guidelines for stable patients recommend surgical or endovascular intervention based largely on aortic dimensions [82,83], although it is well known that rupture can occur in small aneurysms as well. It has been shown that abdominal aortic FDG uptake is associated with higher wall stress [84] and correlates with instability, symptoms and with macrophage infiltration [85]. Whether FDG uptake can identify patients who will benefit from earlier intervention than that dictated by size remains the subject of several ongoing studies.…”

Section: The Potential Of Fdg-pet Imaging In Aortic Aneurysm and Aortmentioning

confidence: 99%

Vascular imaging with positron emission tomography

Joshi

Rosenbaum

Bordes

et al. 2011

Journal of Internal Medicine

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Atherosclerosis is an inflammatory disease that causes most myocardial infarctions, strokes and acute coronary syndromes. Despite the identification of multiple risk factors and widespread use of drug therapies, it still remains a global health concern with associated costs. Although angiography is established as the gold standard means of detecting coronary artery stenosis, it does not image the vessel wall itself, reporting only on its consequences such as luminal narrowing and obstruction. MRI and computed tomography provide more information about the plaque structure, but recently positron emission tomography (PET) imaging using [ 18 F]-fluorodeoxyglucose (FDG) has been advocated as a means of measuring arterial inflammation. This results from the ability of FDG-PET to highlight areas of high glucose metabolism, a feature of macrophages within atherosclerosis, particularly in high-risk plaques. It is suggested that the degree of FDG accumulation in the vessel wall reflects underlying inflammation levels and that tracking any changes in FDG uptake over time or with drug therapy might be a way of getting an early efficacy readout for novel anti-atherosclerotic drugs. Early reports also demonstrate that FDG uptake is correlated with the number of cardiovascular risk factors and possibly even the risk of future cardiovascular events. This review will outline the evidence base, shortcomings and emerging applications for FDG-PET in vascular imaging. Alternative PET tracers and other candidate imaging modalities for measuring vascular inflammation will also be discussed.

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“…Growing evidence show that an increase in 18 F-FDG uptake is a latent signal in the aorta with active atherosclerotic inflammation (59,60). Many studies have attempted to use 18 F-FDG to evaluate aortic diseases (61)(62)(63)(64)(65)(66)(67).…”

Section: Metabolism Activitiesmentioning

confidence: 99%

Molecular targets in aortic aneurysm for establishing novel management paradigms

Zhu

et al. 2017

J. Thorac. Dis.

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Aortic aneurysm (AA) is a lethal disease and presents a large challenge for surgeons in the clinic.Although surgical management remains the major choice of AA, operative mortality remains high. With advances in understanding of the mechanisms of AAs, molecular targets, such as matrix metalloproteinases (MMPs), D-dimer, and inflammation markers, including C-reactive protein, interleukins and phagocytes, are important in the pathology of development of AA. These markers may become important for improving the diagnostic quality and provide more therapeutic choices for treatment of AA. Although these new markers require long-term trials before they can be translated into the clinic, they can still be helpful in determining new directions. The main aim of this review is to discuss the current findings of molecular targets in progression of AA and discuss the potential application of these new targets for managing this disease.

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High Levels of 18F-FDG Uptake in Aortic Aneurysm Wall are Associated with High Wall Stress

Abstract: These preliminary observations point to a potential link between high wall stress and accelerated metabolism in aortic aneurysm wall and warrant further large population-based studies.

Cited by 89 publications

References 15 publications

¹⁸F-FDG Uptake Assessed by PET/CT in Abdominal Aortic Aneurysms Is Associated with Cellular and Molecular Alterations Prefacing Wall Deterioration and Rupture

¹⁸F-FDG Uptake Assessed by PET/CT in Abdominal Aortic Aneurysms Is Associated with Cellular and Molecular Alterations Prefacing Wall Deterioration and Rupture

Vascular imaging with positron emission tomography

Molecular targets in aortic aneurysm for establishing novel management paradigms

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High Levels of 18F-FDG Uptake in Aortic Aneurysm Wall are Associated with High Wall Stress

Abstract: These preliminary observations point to a potential link between high wall stress and accelerated metabolism in aortic aneurysm wall and warrant further large population-based studies.

Cited by 89 publications

References 15 publications

18F-FDG Uptake Assessed by PET/CT in Abdominal Aortic Aneurysms Is Associated with Cellular and Molecular Alterations Prefacing Wall Deterioration and Rupture

18F-FDG Uptake Assessed by PET/CT in Abdominal Aortic Aneurysms Is Associated with Cellular and Molecular Alterations Prefacing Wall Deterioration and Rupture

Vascular imaging with positron emission tomography

Molecular targets in aortic aneurysm for establishing novel management paradigms

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Product

Resources

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¹⁸F-FDG Uptake Assessed by PET/CT in Abdominal Aortic Aneurysms Is Associated with Cellular and Molecular Alterations Prefacing Wall Deterioration and Rupture

¹⁸F-FDG Uptake Assessed by PET/CT in Abdominal Aortic Aneurysms Is Associated with Cellular and Molecular Alterations Prefacing Wall Deterioration and Rupture